The influence of hostile neck anatomy on endoleaks after endovascular aneurysm repair
10.3760/cma.j.issn.1007-631X.2012.07.002
- VernacularTitle:腹主动脉瘤腔内修复术中不良近端锚定区对内漏的影响
- Author:
Hongpeng ZHANG
;
Wei GUO
;
Xiaoping LIU
;
Xin JIA
;
Jiang XIONG
;
Xiaohui MA
;
Minhong ZHANG
;
Yongle XU
- Publication Type:Journal Article
- Keywords:
Aortic aneurysm;
abdominal;
Angioplasty;
balloon;
Stents
- From:
Chinese Journal of General Surgery
2012;27(7):523-526
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the influence of hostile neck anatomy on type Ⅰ a endoleak development after endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysmal disease.Methods From July 2008 to July 2011,195 consecutive patients with non-ruptured abdominal aortic aneurysms (AAA) were treated with EVAR.There were 150 males and 45 females,aging from 52 to 95 years with a mean of 69 years.Forty-three patients were with hostile neck anatomy ( HNA ).High-resolution computed tomography was abtained in all patients,with detailed measurement of proximal neck parameters.Univariate and multivariate analyses were used to compare Ⅰ a endoleak and HNA.Follow-up protocol consisted of computed tomography (CT) angiograms or ultrasound at 3,6,and 12 months,and annually thereafter.Results Twenty-three patients had intraoperative type Ⅰ a endoleaks.The adjunctive measures,such as repeated balloon angioplasty,cuff extension,Palmaz stent placement and chimney technique were used for treating type Ⅰ a endoleak.Small endoleak remained in only one patient.The technical success rate was 98.5％ (192/195).The association between type Ⅰ a endoleak development and magnitude of the infrarenal angle was statistically significant.The mean follow-up time was ( 18 ± 3 )months.The survival rates at 1- and 3-year were 97.4％ and 89.2％ respectively.Conclusions The proximal neck angle is related to intraoperative type Ⅰ a endoleak occurrence,but other factors often thought to be indicative of adverse neck anatomy are not significant predictors.Most type Ⅰ a endoleaks in this study were uccessfully eliminated intraoperatively with a satisfactory mid to long term results.
